BLOOD

TRANSFUSION
Indications -
• Acute hemorrhage.
• Major operations.
• Deep burns.
• Pre-operative.
• Post-operative.
Indications -
• Chronic anemia.
• Severe malnutrition & hypoproteinemia.
• Coagulation disorders.
• Erythroblastosis foetalis.
• During chemotherapy.
Collection of blood -
• Check for transmittable diseases.
• 15 gauge needle.
• Median cubital vein.
• Container with 75 ml. of anticoagulant.
• Specimen for grouping.
• About 410 ml. of blood drawn.
Anticoagulant solutions -
1. CPD solution.
2. CPDA-1 solution.
CPD solution -
1. Trisodium citrate.
2. Citric acid.
3. Sodium dihydrogen phosphate &
4. Dextrose mixed with water.
• Shelf-life of blood is about 3 wks.
CPDA-1 solution -
• Adenosine is added to CPD solution.
• Increases shelf-life up to 5 wks.
Blood storage -
• Stored at temp. ranging from 2-6* c.
• Erythrocytes loose their ability to
release oxygen by 7 days.
• WBC are destroyed within 24 hrs.
• Platelets & clotting factors are
destroyed within 36-48 hrs.
Types of blood transfusion -
1. Typical stored blood transfusion.
2. Warm blood transfusion.
3. Filtered blood transfusion.
4. Auto transfusion.
5. Exchange transfusion.
Blood groups -
• Group A –

Red cell contains A agglutinogen &

serum contains anti-B agglutinin.
Blood groups -
• Group B –

Red cell contains B agglutinogen &

serum contains anti-A agglutinin.
Blood groups -
• Group AB –

Red cell contains both A & B

agglutinogen & serum contains neither
anti-A or anti-B agglutinin.

• Universal recipient.
Blood groups -
• Group O –

Red cells contain neither A nor B

agglutinogen & serum contains both
anti-A & anti-B agglutinins.

• Universal donor.
RH factor-
• Antigen found in red cells.
• Individual is divided into positive or
negative based on its presence or
absence.
• 85% of population is Rh positive, 15%
are Rh negative.
Technique of blood grouping-
• On a slide with stock serum.
Complications of transfusion-
• Transfusion reactions-
1. Incompatibility.
2. Pyrexial reactions.
3. Allergic reactions.
4. Sensitisation to leucocytes & platelets.
Incompatibility-
• Incompatible transfusion.
• Transfusion of haemolysed blood.
• Transfusion of blood after expiry date.
Incompatibility-
• Clinical features-
– Rigor & fever.
– Headache, nausea & vomiting.
– Tightness in chest & dyspnoea.
– Pain in loins- indicates blockage of renal
tubules.
– Tingling sensation in the extremities.
Incompatibility-
• Haemoglobinuria occurs within 2-3 hrs.
• Jaundice appears within 24-36 hrs.
• Acute renal failure will be the end
result.
Incompatibility-
• Treatment-
– Stop transfusion.
– Check the labels, Repeat cross matching.
– IVF should be started.
– Alkalization of blood reduces precipitation
of haematin pigments.
– 10 ml. isotonic solution of sodium lactate &
10 ml. saturated solution of sodium
bicarbonate, given IV.
Incompatibility-
• Treatment-
– Antihistamine & hydrocortisone can be
used.
– Hemodialysis.
Pyrexial reactions-
• Pyrexia, chill, rigor can occur during
transfusion.
• Causes-
– Unsterile transfusion set.
– Very rapid transfusion.
– Presence of pyrogens in donor apparatus.
Pyrexial reactions-
• Treatment-
– Stop transfusion temporarily.
– Antpyretics & antihistamines are given.
– Transfusion restarted with fresh set.
Allergic reactions-
• Due to allergic reaction to plasma of
donor’s blood.
• Stop transfusion.
• Antihistamines & hydrocortisone will
help.
Complications of transfusion-
• Transmission of diseases-
1. Serum hepatitis.
2. AIDS.
3. Bacterial infections.
General complications-
1. Thrombophlebities.
2. Air embolism.
Complications due to massive transfusion-

1. Acid-base imbalance.
2. Hyperkalaemia.
3. Citrate toxicity.
4. Hypothermia.
5. Failure of coagulation.
‘The best amount of blood to give is

the least amount that is needed’